#PATHOLOGY(INICET)
Q- HLA antigens observed on ocular dendritic cells are:
A. Class I
B. Class II
C. Class I and II
D. None
Answer is B. Class II
▪️The human MHC, known as the human leukocyte antigen (HLA) complex, consists of a cluster of genes on chromosome 6
▪️Based on their chemical structure, tissue distribution, and function, MHC gene products fall into two main categories: class I & class II
▪️Class, I MHC molecules are encoded by three closely linked loci, designated HLA-A, HLA-B, and HLA-C
▪️They are found on the cell surface of all nucleated cells in the bodies of vertebrates. They also occur on platelets, but not on red blood cells. ▪️Their function is to display peptide fragments of proteins from within the cell to cytotoxic T cells; this will trigger an immediate response from the immune system against a particular non-self antigen displayed with the help of an MHC class I protein.
▪️Class II MHC molecules are encoded by genes in the HLA-D region, which contains at least three subregions: DP, DQ, and DR.
▪️They are found in antigen-presenting cells such as dendritic cells, mononuclear phagocytes, some endothelial cells, thymic epithelial cells, and B cells. These cells are important in initiating immune responses.
Q- Best blood product to be given in a patient of multiple clotting factor deficiency with active bleeding:
A. Whole blood
B. Packed RBCs
C. Fresh frozen plasma
D. Cryoprecipitate
Answer is C: Fresh frozen plasma
Best blood product for multiple clotting factor deficiency patient with active bleeding - Fresh frozen plasma.
Fresh frozen plasma (FFP):
Contains stable coagulation factors.
Plasma proteins - Fibrinogen, antithrombin, albumin, proteins C & S.
Indications:
▪️Correction of coagulopathies
▪️Rapid warfarin reversal
▪️Supplying deficient plasma proteins
▪️Treatment of thrombotic ▪️thrombocytopenic purpura
▪️IgA-deficient patients
Plasma support by FFP from IgA-deficient donors to prevent anaphylaxis.
Q- Myelofibrosis leading to a dry tap on bone marrow aspiration is seen with ach of the following conditon
A. Burkitt's lymphoma
B. Acute erythroleukemia
C. Acute megakaryocytic leukemia
D. Acutemyelomonocytic leukemia
Answer-> C. Acute megakaryocytic leukemia
Bone marrow maybe difficult to aspirate in Acute megakaryocytic leukemia and more than 2/3rd of patients have significant fibrosis caused by release of fibrogenic cytokine
Erythroleukemia (M6) FAB
Bone marrow findings:
🔹Usually hypercellular with megaloblastic changes°
🔹 Erythroid precursors commonly have multicentricity (65%), karyorrhexis (53%), morulae (25%) and cytoplasmic inclusions°.
🔹MC immunophenotypic marker for erythroleukemia: Glycoprotein 7 and transferring receptor (CD-71
Acute Megakaryocytic Leukemia (M7) FAB
Bone marrow findings:
Bone marrow maybe difficult to aspirate and more than 2/3' of patients have significant fibrosis° caused by release of fibrogenic cytokine
Burkitt's Lymphoma
Bone marrow findings:
When the bone marrow is involved, aspirates reveal tumor cells with slightly clumped nuclear chromatin°, 2-5distinct nucleoli and royal blue cytoplasm containing clear cytoplasmic vacuole
Acute Myelomonocytic Leukemia (M4) FAB
Bone marrow findings:
Ultra-structures are present in association with monocytosis and myeloblastic/monoblastic infiltration of bone
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